Focal Shockwave vs Radial Shockwave Therapy – What’s the Difference and Which Helps Plantar Fasciitis?

By Unpain Clinic on October 6, 2025

Introduction

Chronic heel pain or tendon injuries can feel defeating. Every morning, stepping out of bed brings that sharp sting in your heel. You’ve tried rest, stretches, maybe even injections – yet the pain persists. If this sounds familiar, you’re not alone, and there is hope. Many patients are now turning to advanced therapies like shockwave therapy for relief.

But what is focal shockwave therapy, and how does it compare to the more common radial shockwave therapy? If you’re searching for focal shockwave therapy for plantar fasciitis near me in hopes of a cure, it’s crucial to understand the differences. In this post, we’ll demystify focal vs radial shockwave therapy and explore how the right approach may finally help your stubborn pain heal.

Plantar fasciitis – one of the most common causes of heel pain – is a prime example. It’s a condition that can become frustratingly chronic. The thick band of tissue under the foot (plantar fascia) becomes inflamed and micro-torn, leading to intense pain with every step. Traditional treatments often fall short because they fail to address why the fascia got injured in the first place. We empathize with how debilitating this can be.

The good news? Focal extracorporeal shockwave therapy (ESWT) may offer lasting relief where other treatments haven’t. First, let’s clarify the difference between focal and radial shockwaves, so you know what to expect.

Problem: Why Pain Persists in Plantar Fasciitis and Tendinopathy

Plantar fasciitis and other tendinopathies (like Achilles tendonitis, tennis elbow, or rotator cuff injuries) often become chronic because the underlying issues aren’t addressed. In plantar fasciitis, factors like tight calves, weak foot muscles, or poor biomechanics put extra strain on the plantar fascia[1]. You might have a job or hobby that keeps you on your feet, or perhaps your hips and core aren’t absorbing impact properly, forcing your feet to overwork. Over time, micro-tears and inflammation in the fascia accumulate. The body tries to heal, but repeated stress exceeds the healing rate, leading to a constant cycle of pain and partial healing.

It doesn’t help that tendons and fascia have a limited blood supply, so they heal slowly. Every morning when you feel that stabbing heel pain (classic in plantar fasciitis), it’s a sign the tissue is stuck in a chronic inflammatory state. Standard remedies—ice, anti-inflammatories, night splints, shoe inserts—may give temporary relief but often don’t solve the problem. In fact, treatments like cortisone injections can weaken tissues, providing a short reprieve at the risk of further damage down the line. The real issue is usually a combination of tissue damage and biomechanical dysfunction.

For example, a patient’s chronic heel pain might actually stem from tight hamstrings or misaligned hips altering their gait. Simply treating the foot alone isn’t enough if those root causes remain. This is why pain persists – we chase symptoms instead of fixing causes. What’s needed is a therapy that not only reduces pain, but also kickstarts genuine healing in the damaged tissue and a whole-body approach to correct the contributing factors. This is where shockwave therapy comes in. But to choose the right shockwave treatment, we must understand focal vs radial shockwave therapy.

Focal vs. Radial Shockwave: What’s the Difference?

Both focal and radial shockwave therapies use acoustic waves to stimulate healing in injured tissues, but they are not the same. In fact, the term “shockwave therapy” often refers to two distinct technologies:

Focal Shockwave Therapy (True ESWT): Also known as focused shockwave, this generates high-energy sound waves that converge at a specific focal point deep in the tissue. The energy can penetrate deeper areas (up to 4–6 cm or more) with high intensity. Focal shockwaves deliver a concentrated impact – think of it like a precise blast of energy aimed right at the problem spot. The peak pressure of a focused shockwave is extremely high (tens of megapascals), on the order of 100 times greater than radial waves.

This is the classic “extracorporeal shockwave therapy” used in many research studies. It was originally developed to break up kidney stones, and doctors noticed it could also stimulate bone and tissue healing. Focal ESWT is excellent for deep, chronic conditions and precise targets – for example, a stubborn plantar fascia attachment or calcified shoulder tendon.

Radial Shockwave Therapy (Radial Pressure Wave): Radial shockwave devices (technically, these create pressure waves rather than true shock waves) emit lower-energy pulses that disperse outwards from the applicator head. The maximum energy is delivered at the skin surface and then radiates into the tissue, typically affecting more surface-level tissues (roughly 3–5 cm deep). Radial shockwave covers a broader area with less intensity – imagine a shotgun spread versus the sniper focus of focal ESWT.

This modality is often used for muscle tightness, trigger points, and superficial tendon issues. It increases blood flow and helps with pain, but because it’s less intense and less focused, it may be better suited for milder or more diffuse problems. In truth, radial “shockwave” is a bit of a misnomer; due to its lower pressure and slower energy, it’s not a “true” shockwave in the physics sense. But it can still be therapeutic for certain conditions.

In simpler terms, focal ESWT is like a targeted laser, whereas radial is like a broad flashlight. Focal shockwave can reach deeper structures and deliver more powerful energy to stimulate healing in a precise spot. Radial shockwave treats a wider, more superficial area and at a gentler energy level.

At Unpain Clinic, we utilize both types depending on the patient’s needs. For example, for plantar fasciitis and heel spurs, we often use focal shockwave therapy for the deep fascial lesions, and we may add radial shockwave around the foot or calf for more superficial muscle tightness. This combination ensures that both the primary injury and the surrounding tension are addressed.

Which one is right for you?

It depends on your condition. Generally, focused shockwave is preferred for chronic, deep conditions like plantar fasciitis, Achilles tendinopathy, deep hip or hamstring tendons, and calcific tendinitis in the shoulder. It’s also the type used for regenerative therapies in men’s health (more on that later). Radial shockwave is often used for larger surface areas or more generalized pain, like broad myofascial pain syndromes, IT band syndrome, or muscle trigger points in the back and neck.

In some cases, radial can be a cost-effective “maintenance” or “tune-up” treatment – for instance, after a course of focused ESWT, a patient might get the occasional radial wave session to keep minor aches at bay (indeed, our clinic offers “radial pressure wave tune-ups” at a lower cost for this purpose).

The key takeaway is that focal and radial shockwaves are complementary tools. Neither is “better” in all situations; it’s about matching the right tool to the condition. Next, we’ll look at what research says about how shockwave therapy – especially focal ESWT – can help heal chronic pain conditions like plantar fasciitis that haven’t responded to conventional care.

What Research Says: Evidence for Shockwave Therapy

Modern research has increasingly supported shockwave therapy as a game-changer for chronic musculoskeletal conditions. Plantar fasciitis is one of the most well-studied examples. Numerous clinical trials and reviews show that extracorporeal shockwave therapy (ESWT) can significantly reduce pain and improve function in chronic plantar heel pain.

In fact, a 2025 randomized trial on patients with painful heel spurs (a frequent companion of plantar fasciitis) found that focused shockwave therapy significantly reduced heel pain and improved foot function compared to baseline – morning pain scores dropped from about 7.8/10 to 3.4/10 after treatment. Patients were able to walk more comfortably and reported better quality of life. Similarly, an 11-study systematic review (658 patients) concluded that shockwave yields moderate improvements in chronic plantar fasciopathy outcomes, outperforming placebo or “sham” therapy in relieving pain.

Impressively, imaging studies have even shown the biological effect: in plantar fasciitis sufferers, a course of shockwave therapy visibly thinned the abnormally thickened plantar fascia on ultrasound, correlating with pain relief and improved mobility. This means the treatment isn’t just numbing the pain – it’s actually reversing the disease process in the tissue.

Shockwave therapy has shown promise in other stubborn tendinopathies as well. For instance, Achilles tendonitis (mid-portion Achilles tendinopathy) often frustrates runners and active individuals for months. Shockwave has been scientifically proven to stimulate tendon healing. Laboratory and clinical evidence confirm that ESWT promotes angiogenesis (new blood vessel formation) in tendon tissue and boosts collagen synthesis – essentially helping the degenerated tendon regenerate stronger. 

Since tendons normally have poor circulation, this influx of blood supply and new collagen is a game-changer for healing. Some studies on Achilles injuries have reported significant pain reduction with shockwave versus placebo or compared to exercise alone, though results can vary. (It’s worth noting that combining shockwave with an eccentric exercise program seems to yield the best outcomes for Achilles problems – addressing both tissue healing and mechanical loading.)

In chronic shoulder tendinopathies like rotator cuff injuries, especially non-calcific tendinitis, research indicates both focused and radial shockwave can be effective at reducing pain and improving arm function. However, focused shockwave may have an edge for long-term results. A randomized clinical trial in 2021 treated patients with chronic rotator cuff tendinopathy using either focused ESWT or radial wave therapy. In the first 3-6 months, both groups improved similarly in pain and shoulder function. 

By 6-12 months out, the focused shockwave group had significantly greater pain relief and better shoulder scores than the radial group. In fact, at nearly one year after treatment, patients who received focal shockwave rated their pain about half as much as those who had radial treatment. This suggests that for deeper soft-tissue problems, the higher-energy focused waves create more lasting tissue changes, whereas radial waves might provide shorter-term palliative relief.

What about tennis elbow (lateral epicondylitis) or patellar knee tendinopathy?

These, too, have been studied with ESWT. Systematic reviews have generally found shockwave to be a safe and possibly effective option when other conservative treatments fail. For tennis elbow, some trials show improved grip strength and reduced pain after a series of shockwave sessions, comparable to or better than steroid injections – without the side effects of steroids.

Patellar tendinopathy (jumper’s knee) evidence is mixed, but a 2023 meta-analysis noted that while shockwave alone had only a small short-term effect for patellar tendon pain, combining shockwave with exercise provided better outcomes than exercise alone. And notably, for plantar fasciitis (PF) in that same analysis, the authors concluded there is high-quality evidence that shockwave has a large effect on pain and function for PF, making it one of the top recommended treatments for chronic plantar fasciitis.

Importantly, radial wave devices have not shown similar success in this area – a Cleveland Clinic review emphasized that only fSWT has shown positive results in clinical trials for ED, whereas rWT (radial wave therapy) has not proven effective in any controlled trials to date. This highlights that the two modalities are not interchangeable: when depth and true tissue change are required (like reviving blood flow in ED or healing a recalcitrant tendon), focused shockwave is the superior choice. Radial may still play a supportive role for more superficial pain or in combination with other therapies.

The bottom line from the research: Shockwave therapy is a powerful, evidence-backed tool for chronic pain conditions that involve poor healing or degeneration of tissues. Plantar fasciitis is a standout example where focal shockwave therapy can provide significant relief and functional improvement – even when other treatments (medication, orthotics, injections) have failed. It achieves this not by masking pain, but by jump-starting the body’s own repair mechanisms.

The high-energy pulses cause mechanical stress that leads to biological healing responses: improved blood circulation, release of growth factors, dissolution of calcifications, and new tissue regeneration. Patients often report that after a course of ESWT, their pain not only diminishes, but they can walk or exercise more normally again – a sign of true recovery.

Of course, shockwave is not a magic wand or an instant cure. It works best as part of a comprehensive approach to the condition. That’s why at Unpain Clinic, we combine focal shockwave therapy with other complementary treatments to ensure we fix the why of your pain, not just the where.

Treatment Options at Unpain Clinic: A Whole-Body Approach

At Unpain Clinic, we take a holistic, root-cause approach to pain. If you come in with plantar fasciitis (or any chronic issue), our first step is a thorough assessment to identify all the contributing factors – often, the true problem isn’t exactly where it hurts. Once we map out the root causes, we design a tailored treatment plan. 

Shockwave therapy (especially focal ESWT) is often a centerpiece of our plans, but it’s never the only tool we use. Pain is multifaceted, so our treatment strategy is as well. Here are the key modalities we might combine to get you better:

Shockwave Therapy (Focal and Radial)

We use state-of-the-art shockwave devices, including both focused and radial applicators. True focal shockwave therapy is typically applied to the primary site of tissue damage – for example, the insertion of the plantar fascia on the heel bone or the chronically inflamed Achilles tendon. These high-energy waves penetrate deep to break up scar tissue and calcifications, increase local blood flow, and trigger cellular repair.

Patients usually receive treatment on the first visit, and most undergo about 3 sessions of shockwave (spaced roughly one week apart) for a given problem. Each session is quick (around 10–15 minutes of actual shockwave application) and non-invasive. No anesthesia is needed; the treatment might cause a brief tingling or pressure sensation, especially if we hit a bony area, but it’s very tolerable – any discomfort stops immediately when the machine is paused. In fact, most clients describe it as more weird than painful, and only for a few seconds at a time. We adjust the intensity to keep you comfortable while still delivering effective energy.

We may incorporate radial shockwave therapy in addition to focal, depending on your case. For instance, if you have plantar fasciitis with a very tight calf and hamstrings, we might use radial shockwave over the calf muscle to relieve myofascial tension while using focal shockwave on the plantar fascia itself. Radial shockwave is great for surface tissue release – it feels like a strong percussive massage that stimulates circulation in the muscles and fascia. By using both types, we ensure the entire chain of tissue – both the deep injury and the surrounding tight structures – are being treated.

The goal of shockwave therapy, as we often say, is to “stimulate the body’s natural repair mechanisms”. Unlike a quick fix that just numbs pain, shockwave prompts your body to actively heal. Many patients start to feel improvement after the first session or two – for example, slightly less morning pain or a shorter duration of pain each day. By the end of a full course (say 3-5 sessions), the majority report substantial relief: “I can finally walk without that stabbing pain”. Of course, individual results vary (and we always remind patients: results may vary, and healing takes time). But the evidence and our clinical experience both point to shockwave as a highly effective component for these hard-to-treat conditions.

EMTT (Electromagnetic Transduction Therapy)

In addition to shockwaves, our clinic is proud to offer Extracorporeal Magnetotransduction Therapy (EMTT) – a cutting-edge pulsed electromagnetic field therapy. EMTT is a newer modality that complements shockwave by targeting inflammation at the cellular level. Whereas shockwave is mechanical (sound waves), EMTT uses high-frequency electromagnetic pulses delivered to the area of pain. 

EMTT helps reduce inflammation and modulate pain signals without any sensation of pain or pressure. It’s kind of like an MRI-strength magnet rapidly pulsing – you don’t feel it much, maybe a mild warmth – but it calms down overactive nerves and kick-starts cell repair processes. We often add EMTT for very chronic conditions or sensitive individuals because it calms hyperactive nerves that keep sending pain signals.

Think of EMTT as telling the nerves “shhh, quiet down” while shockwave is telling the tissues “time to rebuild!”. This one-two punch can significantly speed up recovery. Clinical support for EMTT is growing, with studies indicating benefits for musculoskeletal pain and even nerve pain. And since it’s non-invasive and painless, there’s no downside to including it.

Neuromodulation Techniques

Chronic pain can cause the nervous system to become sensitized. Sometimes even after the tissue heals, the nerves still “remember” the pain and keep misfiring. That’s why we incorporate gentle neuromodulation techniques when needed, especially if your pain has a nerve component. For long-standing plantar fasciitis, for example, the tibial nerve or its branches in your foot may become overactive, perpetuating pain. 

Our physiotherapists may use low-level laser therapy or specific electrical stimulation to the affected nerves to help “reset” their activity. We might also teach you nerve gliding or “nerve flossing” exercises if appropriate. The aim is to normalize nerve function so that normal movement no longer triggers a pain alarm.

Neuromodulation treatments are typically soothing – patients often report a gentle warmth or tingling, but no significant discomfort. By pairing this with shockwave, we address both the hardware (tissue damage) and the software (nerve signaling) of your pain condition.

Manual Therapy

No comprehensive treatment plan is complete without hands-on care. Our skilled physiotherapists and chiropractors provide manual therapy to correct joint misalignments, release tight tissues, and improve your biomechanics. In the context of plantar fasciitis or Achilles issues, this might mean mobilizing the joints of the foot and ankle, performing deep tissue release on the calf muscles, or adjusting the hips and spine if we find alignment issues. For example, if your ankle is stiff and you lack upward movement (dorsiflexion),it can overload the plantar fascia – so we do joint mobilizations and calf release to restore that motion. 

If your assessment shows hip or pelvic misalignment, we include appropriate spinal or pelvic adjustments to ensure your legs and feet are operating on a stable, aligned base. As one satisfied patient noted in her review, the therapists at Unpain Clinic “provide shockwave with every visit” but also “treat secondary problem areas (i.e. a sore foot can affect your knees, etc.), because they look at the whole chain”.

This whole-chain manual therapy approach means we aren’t just focusing on the foot while ignoring the rest – we actively work on any tight, weak, or misaligned areas that could be contributing to your pain. The result is often improved flexibility, better posture, and a feeling that your body is moving more freely and correctly, which is crucial for long-term relief.

Targeted Exercise and Rehabilitation

Last but certainly not least, exercise therapy is a pillar of our approach. Between your visits to the clinic, we empower you with a tailored exercise program you can do at home. Why? Because building strength, flexibility, and stability will solidify the improvements from the treatments. For plantar fasciitis and similar conditions, research shows that once pain is reduced, rehab exercises greatly enhance outcomes. Our team will prescribe moves that are appropriate for your stage of healing – often a combination of stretching, strengthening, and motor control exercises specific to your needs.


For example, a typical at-home plan for plantar fasciitis might include:
Calf stretches: to ease tension in the Achilles and plantar fascia. (How to do it: Stand facing a wall, one leg back with knee straight and heel down, lean forward until you feel a gentle stretch in the calf; hold 20–30 seconds).*
Plantar fascia stretches: to lengthen the arch. (E.g.: Sit and cross one foot over the opposite knee, then gently pull your toes back toward your shin until you feel the stretch in your arch; hold 20–30 seconds).
Foot rolling massage: to reduce fascial tightness. (Roll your foot over a frozen water bottle or a lacrosse ball for a few minutes daily; the pressure plus cold can reduce inflammation).
Strengthening exercises: to build resilience. Once your acute pain subsides, we might add towel curls (scrunching a towel with your toes) and calf raises to strengthen the foot intrinsic muscles and calf. For Achilles issues, we’d include eccentric heel drops; for knee pain, maybe quadriceps and glute exercises, etc.
Balance and functional drills: if needed, to improve how your whole kinetic chain works (for instance, single-leg balances or hip stability exercises so your gait improves).

We will also coach you on footwear (choosing supportive shoes, avoiding barefoot walking on hard surfaces during recovery) and pain management (when to ice, when to rest, and when to push yourself a bit). A key point we emphasize: listen to your body. Some soreness after using new muscles is normal, but sharp pain is a signal to ease up. 

By diligently doing your home exercises, you help ensure that once the shockwave and other therapies calm down the inflammation, your foot or affected area stays healthy and doesn’t just get re-injured. These exercises essentially retrain your body to move correctly and build strength in the previously weak link.

All these elements – shockwave (focal/radial), EMTT, neuromodulation, manual therapy, and exercise – come together in a comprehensive program. By combining these therapies, we treat the root causes of your pain, not just mask the symptoms. Unlike a standard care approach that might only address the sore spot (and wonder why the pain returns), Unpain’s integrative method looks at how your foot, leg, and entire body are connected. Our aim is to fix the dysfunctions that led to the injury in the first place.

This way, you get not only relief, but also a plan to prevent the issue from recurring. It’s a truly individualized strategy – no two patients’ programs are exactly alike, because everyone’s “why it hurts” is different. Our clinicians continuously adjust the treatment mix based on your progress. If something’s not improving, we re-evaluate and modify the plan.

This whole-body, personalized care is what sets us apart. We’ve seen time and again that it yields results where cookie-cutter therapies fail. But you don’t have to take our word for it – listen to our patients.

Patient Story: Real Relief After “Trying Everything”

It always helps to hear from someone who has walked the same road of pain. One patient, for example, came to us with a decade-long history of plantar fasciitis. She had literally “tried all kinds of treatments for my plantar fascia” – custom orthotics, night splints, multiple cortisone shots, endless physio sessions elsewhere – yet the pain in her foot never fully went away. She was growing hopeless that anything could fix it.

At Unpain Clinic, we performed a full assessment and implemented the kind of program described above: focused shockwave therapy to her plantar fascia and calf, EMTT for the inflammation, some hip adjustments, and a home exercise regimen. After a few weeks, she experienced a breakthrough. 

In her words, “Shockwave Therapy is the only thing that has helped relieve the pain in my foot.” This was after years of failed treatments. With continued care, she finally achieved lasting relief and got back to being active on her feet. Stories like this are what inspire us – seeing a patient reclaim their mobility and happiness after thinking they’d just have to live with pain.

In another case, a patient came in expecting a quick fix for her heel spur. She assumed we’d just adjust her foot and be done. Instead, during our assessment, the therapist discovered that her hip alignment was a bigger issue. This patient recalls, “He was able to determine my hips were unaligned… Instead of fixing the trouble area, we went above and beyond to figure out what the main problem is.” 

By treating her hip and foot together, and using shockwave on her plantar fascia, she achieved significantly better outcomes than she ever did treating the heel alone. It turned out her hip imbalance was causing abnormal forces on her foot. Once corrected, the heel pain eased and finally healed with the help of shockwave therapy. These stories highlight a crucial point: effective pain relief isn’t just about the tool (shockwave), but also about the philosophy of care.

We strive to treat the person, not just the site of pain. (Names and specific details are withheld for privacy, but these are genuine experiences from Unpain Clinic clients.)
Many of our patients say this whole-body approach “made all the difference” after they had been disappointed by more isolated treatments elsewhere.

It’s not uncommon for people to come to us feeling like they’ve “tried everything and felt nothing” – only to finally see improvement when we apply shockwave and comprehensive care. We’re honored to help turn those stories around, getting people back to pain-free living.

At-Home Guidance: Supporting Your Healing Between Visits

Professional therapy is key to recovery, but your daily habits also play a big role in success. We’ve already touched on some exercises that might be prescribed. Here we’ll recap a few simple, safe things you can do at home to support your healing between clinic sessions. These tips focus on plantar fasciitis as an example, but the general idea – keep tissues limber, build strength gently, and avoid re-strain – applies to many conditions.

1. Stretch regularly (but gently). Keeping the affected area flexible can reduce stress on it. For heel pain, do the calf stretch and plantar fascia stretch described earlier once or twice a day. Stretch after a bit of movement (like after a short walk or warm shower) so your tissues are warm. Never force a stretch into sharp pain – you should feel a mild, tolerable pull. Consistent gentle stretching helps prevent the calf and foot muscles from reverting to a tight state that tugs on your heel.

2. Use ice or cold therapy for flare-ups. If your foot (or whichever area) feels very sore or swollen after activity, apply ice in a smart way. We recommend the frozen water bottle roll: freeze a plastic water bottle and in the evening roll it under your arch or sore spot for 5-10 minutes. This gives a nice combination of massaging pressure and cold to curb inflammation. Alternatively, an ice pack wrapped in cloth for 10-15 minutes can numb pain and reduce swelling. Do keep a layer (like a thin towel) between ice and skin to avoid ice burn.

3. Strengthen the weak links. When pain is under better control (often after a couple of shockwave sessions), start doing your therapeutic exercises as instructed by your therapist. This may include things like towel scrunches, toe curls, or picking up marbles with your toes to strengthen your foot muscles. Calf raises (heel lifts) are great once your plantar pain subsides, to build a more robust Achilles and arch. If you’re rehabbing an Achilles or knee, you’ll have specific moves like eccentric heel drops or squats. The principle is: build resilience in the tissue so it can handle daily demands without getting re-injured. Go slow and focus on form – quality over quantity. These exercises might seem tedious, but over a few weeks you’ll notice more stability and less pain.

4. Mind your footwear and activity. Supportive shoes can make a world of difference, especially for foot and knee issues. Wear shoes with good arch support and cushioning, particularly when you’ll be on your feet a lot. Avoid walking barefoot on hard floors if you’re in a flare of heel pain – even at home, a comfy supportive sandal or sneaker is better than hard bare feet on tile. Gradually increase your activity level; don’t go from resting to a 5 km run overnight. If you’ve been inactive due to pain, your tissues need time to readapt. Follow the plan we give you for returning to exercise or work tasks. And incorporate rest days to allow recovery.

5. Listen to your body. Perhaps the most important advice: pay attention to your pain signals. It’s normal to have some discomfort as you rehab – e.g. muscles may ache as they get stronger, or you might have a “good sore” after exercising. But sharp or worsening pain is a sign to stop and rest. Healing is not linear; there will be better days and worse days. Communicate with your therapist about any setbacks. 

Often we can adjust your treatment or exercises if something is aggravating you. And don’t be discouraged by minor flares – it’s part of the process. Over time, as the shockwave and other treatments reduce the underlying inflammation, you should see your baseline pain getting lower and your flare-ups becoming less intense. Patience and consistency are key.

By following these at-home guidelines, you become an active participant in your recovery. Our Unpain Clinic experts frequently note that rehab is a team effort: what we do in the clinic jump-starts healing, and what you do at home cements those gains. The goal is to not only get you pain-free, but also to equip you with the knowledge to keep yourself healthy. And remember – always check with your provider if you’re unsure about an exercise or if something doesn’t feel right. We’re here to guide you.

Frequently Asked Questions (FAQ)

What conditions can shockwave therapy treat?

Shockwave therapy (ESWT) is used for a wide range of musculoskeletal conditions, especially those involving chronic tendon or fascial pain. Common indications include plantar fasciitis, heel spurs, Achilles tendinopathy, tennis elbow (lateral epicondylitis), golfer’s elbow, rotator cuff tendinopathy (with or without calcifications in the shoulder), patellar tendinopathy (jumper’s knee), shin splints, and certain types of low back or hip pain with muscular components. It’s also used for medial tibial stress syndrome, trochanteric bursitis (outer hip pain), and even to aid healing in stress fractures or non-healing bone fractures. In the realm of men’s health, a focused form of shockwave is used for erectile dysfunction and Peyronie’s disease (penile scar tissue), by improving blood flow and tissue remodeling. Essentially, any condition characterized by chronic inflammation, scar tissue, or poor healing response might benefit from shockwave. At Unpain Clinic, our practitioners will assess if your specific case is appropriate for shockwave. If the problem is a soft-tissue injury that hasn’t healed with time, shockwave may be a good option to stimulate a recovery. However, certain conditions (like acute fresh injuries or complete tendon ruptures) are not treated with shockwave. We always perform a thorough exam to ensure ESWT is safe and likely to help in your case.

How is focal shockwave therapy different from radial shockwave therapy?

The difference lies in the depth and intensity of the treatment. Focal shockwave therapy (also called focused ESWT or “true” shockwave) concentrates high-energy acoustic waves at a precise point deep in the tissue. It can penetrate roughly 4–6 cm or more into the body with very high pressure waves, targeting specific structures like a plantar fascia origin or deep hip tendon. Focused shockwaves stimulate intense biological effects (new blood vessel formation, tissue regeneration) in a small area. Radial shockwave therapy, in contrast, sends out lower-energy pressure waves that spread outward from the device head, affecting a broader, more superficial region (up to ~3–5 cm deep). Radial is not as intense – it’s great for massaging tight muscle knots and increasing circulation, but it doesn’t concentrate force into deep lesions as focused does. Another way to put it: focal shockwave is like pinpointing the injury with a therapeutic “sonic beam,” whereas radial covers the surrounding area with a gentler percussive effect. Both trigger pain relief and healing, but focal is used for deeper, more stubborn pathologies, while radial is used for broader surface issues. Often, clinics (like ours) will use both in combination. It’s worth noting that focal ESWT has more robust evidence in scientific studies for conditions like plantar fasciitis, whereas radial (being a newer, more affordable technology) has mixed results unless used on appropriate superficial targets. We will choose the modality (or mix of both) that best fits your injury.

Can shockwave therapy help plantar fasciitis, and how effective is it?

Yes, shockwave therapy is one of the most effective treatments for chronic plantar fasciitis. Plantar fasciitis (or plantar fasciopathy) is actually the condition for which shockwave gained a lot of its fame. Multiple randomized trials and meta-analyses have confirmed that shockwave can significantly reduce heel pain and improve function in patients who have had plantar fasciitis for many months with no improvement. In fact, current clinical guidelines often recommend considering ESWT for plantar fasciitis that hasn’t responded to first-line interventions. The effectiveness is typically moderate to high: studies have shown pain levels dropping by about 60-70% after a course of therapy, and functional scores (ability to walk, climb stairs, etc.) improving as well. About 70–80% of chronic plantar fasciitis sufferers get meaningful relief from shockwave based on literature. It may take a few weeks after the last session for maximum benefits to kick in, as the tissue keeps healing. It’s not instant, but it’s long-lasting – and importantly, shockwave treats the cause (damaged fascia tissue) rather than just numbing pain. Our own patients have had great success – people who limped in with 9/10 pain are often walking out with 1/10 pain after completing their shockwave series, combined with our other therapies. Of course, individual results vary, and a few people may not respond (or may need more than the standard 3 sessions). But overall, if you have chronic plantar fasciitis, focal shockwave therapy is a highly promising, evidence-backed option before considering more invasive measures like injections or surgery.

How many shockwave therapy sessions will I need, and when will I see results?

The number of sessions can vary based on the condition and its severity, but for chronic musculoskeletal issues we typically start with a protocol of 3 sessions, roughly 1 week apart. This is often enough to trigger significant healing. Some patients indeed feel improvement after just 1 session – for example, a noticeable drop in pain for a day or two that gradually extends longer with each treatment. However, it’s more common that you’ll see a meaningful difference after the third session, with steady progress during the weeks of therapy. If your condition is very severe or long-standing, we might recommend up to 5 or 6 sessions. We space them anywhere from 5 days to 2 weeks apart (about 1 week apart is most common). This spacing allows time for the tissue to react and begin the healing process between shocks. After the final session, we usually wait about a month and do a follow-up: many studies show that healing continues for weeks after the last treatment as new tissue is laid down. If you’re, say, 80% better at the 1-month follow-up but not 100%, we might do another 1-2 sessions at that point. Everyone’s timeline is a bit different. The good news is, unlike therapies that require dozens of visits, shockwave usually requires only a handful of treatments to achieve long-term benefits. And if the root causes are addressed (muscle imbalances, etc.), ideally you won’t need continuous sessions. At Unpain Clinic, our goal is to resolve your issue in as few treatments as necessary, and then perhaps just see you occasionally for maintenance or if you develop a new injury. We will give you a realistic expectation based on your specific case during your initial assessment.

What if I’ve tried everything and nothing has worked – will shockwave therapy finally help?

It’s understandable to be skeptical if you’ve had a “stubborn” condition that hasn’t improved with other treatments. We see many clients in this exact scenario – they’ve done physiotherapy, chiropractic, massage, injections, maybe even surgery, and still have pain. While we can never guarantee results, shockwave therapy offers a fundamentally different approach that might succeed where others failed. Why? Traditional therapies often focus on reducing inflammation or strengthening muscles, which are important, but shockwave goes a step further by actively stimulating tissue regeneration at the cellular level. It can reach deep into tissues that manual therapy or superficial modalities can’t fully influence. Moreover, at Unpain Clinic we combine shockwave with a fresh, whole-body assessment. So it could be that a key piece of the puzzle was missed in your prior treatments – for example, an overlooked biomechanical issue or scar tissue in a related area – and we will aim to find and address that. We have had a lot of success even with rare or “untreatable” cases, precisely because we use advanced tools like ESWT and because we don’t give up on finding the root cause. Our best advice is to come in for an assessment. We’ll give you an honest opinion. If we feel shockwave is not likely to help your specific problem, we will tell you upfront (and not waste your time or money). If we do proceed, we’ll closely monitor your progress. Many patients who were once chronic pain “tough cases” end up turning the corner with our approach – so there is reason to be hopeful. Remember, every treatment is one step closer to finding your solution, and shockwave might just be the one that makes the difference.

Conclusion: Healing Pain at the Source with the Right Shockwave Therapy

Chronic pain conditions like plantar fasciitis can make you feel defeated, but modern therapy offers new avenues for relief. Focused shockwave therapy represents a breakthrough by not just asking “Where does it hurt?” but helping to answer “Why does it hurt?” – and then fixing that why. We’ve seen that the difference between focal and radial shockwave matters: getting the right type (or combination) can mean the difference between temporary relief and lasting recovery. 

Evidence shows that focal shockwave therapy can significantly reduce pain and jump-start healing in stubborn conditions, while radial shockwave adds an extra boost for superficial tissue health. At Unpain Clinic, we leverage both, along with complementary therapies (EMTT, manual care, exercise) to ensure we’re tackling your pain from every angle

If you’re tired of the cycle of “tried everything, nothing works,” we invite you to not lose hope. Our team is passionate about helping patients finally break free from pain by using a whole-body, integrative strategy. Whether it’s that first pain-free step in the morning, the ability to run again, or simply getting through a workday without agony – those goals can be within reach. Many of our patients who once felt stuck now wish they had discovered shockwave therapy sooner.

You don’t have to live with chronic pain as your “new normal.” Let us help your body heal itself with the most advanced, evidence-based tools available. Focal shockwave therapy for plantar fasciitis and other conditions might just be the missing piece in your treatment journey. We’re here to guide you every step of the way, with empathy, expertise, and a commitment to finding what works for you.

Ready to take the next step toward a pain-free life? It starts with a thorough assessment and a personalized plan. We’ll work together to get you back to doing what you love, without pain holding you back.

Book Your Initial Assessment Now

At Unpain Clinic, we don’t just ask “Where does it hurt?” — we uncover “Why does it hurt?”
If you’ve been frustrated by the cycle of “try everything, feel nothing,” this assessment is for you. We take a whole-body approach so you leave with clarity, not more questions.

What’s Included
Comprehensive history & goal setting
Orthopedic & muscle testing (head-to-toe)
Motion analysis
Imaging decisions (if needed)
Pain pattern mapping
Personalized treatment roadmap
Benefit guidance

🕑 Important Details
60 minutes, assessment only
No treatment in this visit
👩‍⚕️ Who You’ll See
A licensed Registered Physiotherapist or Chiropractor
🔜 What Happens Next
If you’re a fit, we schedule your first treatment and start executing your plan.

🌟 Why Choose Unpain Clinic
Whole-body assessment, not symptom-chasing
Root-cause focus, not temporary relief
Non-invasive where possible
No long-term upsells — just honest, effective care

🎯 Outcome
You’ll walk out knowing:
What’s wrong
Why it hurts
The fastest path to fix it

Book Your Initial Assessment Now

Author: Uran Berisha, BSc PT, RMT, Shockwave Expert

References

Goel A. et al. (2022). Extracorporeal shock wave therapy shows comparative results with other modalities for managing plantar fasciitis: A systematic review and meta-analysis. Journal of Orthopaedic Science, 27(4), 812–822.
Li C. et al. (2021). Effectiveness of Focused Shockwave Therapy vs Radial Shockwave Therapy for Non-calcific Rotator Cuff Tendinopathies: A RCT. Biomed Research International, 2021, Article ID 6687094.
Charles R. et al. (2023). The effectiveness of shockwave therapy on patellar tendinopathy, Achilles tendinopathy, and plantar fasciitis: a systematic review and meta-analysis. Frontiers in Immunology, 14, 1193835.
Cleveland Clinic (2023). Trial compares shockwave versus radial wave therapy for erectile dysfunction. Consult QD – Urology, Nov 24, 2023.
Unpain Clinic Podcast (2023). Erase your Achilles pain with the Unpain method – Episode #4 (Uran Berisha, host).
Unpain Clinic Blog (2025). Shockwave therapy for Heel Spurs & Plantar Fasciitis in Edmonton.
Unpain Clinic Patient Review (2025). Shockwave therapy success story – Unpain Clinic – Heel Spur Blog.
Shockwave Canada (2023). Radial or Focused? The Shocking Differences and Benefits. (Overview of applications for radial vs focused shockwaves).
Enovis Medical (2021). Difference between focused shock wave and radial pressure wave therapy. (Technical explanation of energy and depth differences).
Unpain Clinic FAQ. Does shockwave therapy hurt? and How many treatments will I need? – UnpainClinic.com/FAQ.
[1] [2] Shockwave therapy for Heel Spurs & Plantar Fasciitis in Edmonton
https://unpainclinic.com/shockwave-therapy-heel-spur-problems-edmonton/